Automated solutions simplify complex Appeals and Grievances processes and Prior Authorizations enhancing customer satisfaction while maintaining compliance
Appeals and Grievances
When complex, knowledge-based operations rely on manual, paper-based processes, the results are low productivity and a diminishing bottom line. Excellarate’s solutions for Appeals and Grievances solutions help to transform operations.
Faster, Smarter Investigations
Case information is captured, cataloged, and stored in a central location, then automatically prioritized and distributed
Increased Bottom Line
Automated processes reduce incidence of error, maximize resources, and speed up case resolution, reducing administrative costs and maximizing revenue potential
Confidently comply with contractual obligations as well as state, federal, NCQA, and group regulations using case tracking, reporting, and comprehensive audit trails
Higher Customer Satisfaction and Retention
Automated processes and robust digital cataloging system enable faster case resolution and promote rapid member access to care and claim payments
Increased Employee Productivity
All relevant case information is easily stored and accessed in a single location, which eliminates time lost searching for documents and simplifies decision-making
Automated functionality locates and returns information quickly, enabling faster response times to information requests from customers, legal discovery, and regulatory requests
Optimal decision making for authorization requests requires speed and accuracy, but reliance on paper-based processes works against both. For the customer awaiting a specialist or medical procedure, a delay in authorization can be a major source of frustration.
Excellarate’s Prior Authorization solution enables a streamlined authorization processing that eliminates the paper and drives smarter decision-making, better customer service, and higher productivity.